27 Mediastinal and pleural pathology Flashcards Preview

01 Renal Respiratory > 27 Mediastinal and pleural pathology > Flashcards

Flashcards in 27 Mediastinal and pleural pathology Deck (14):
0

Pleural effusion

>15ml in the pleural space

1

Inflammatory pleural effusions

*Serous/fibrinous/serofibrinous- 2/2 infection and infarct
*Empyema
*Hemorrhagic- coagulopathy, rickettsial, neoplasms

2

Empyema treatment

Frequently need to remove affected area of pleura "Decortication"

3

Non-inflammatory Pleural Effusions

Hydrothorax- CHF, cirrhosis, uremia, renal failure
Hemothorax-AAA, trauma
Chylothorax- Milky fluid - lymphatic trauma or occlusion

4

Fibrous tumor

Polypoid-well circumscribed tumors
Fibroblasts and collagenized stroma- spindle cells with collagen
Benign treated with excision

Clubbing and hypoglycemia

5

Malignant mesothelioma

Proliferation of mesothelial cells
*ASBESTOS or idiopathic
Long latency
Ferrigenous bodies
18 month survival

6

Mesothelioma histo

Normal mesothelial appearance- difficult to distinguish from metastatic carcinomas to pleura
*Epitheliod cuboidal appearance
*Spindle cell type with collagen and spindle cells

7

Pleural mets

More comman than primary pleural malignanccy
usually multinodular and bilateral
blood, lymph, or direct spread

8

Mediastinal pathology

Inflammatory
-Acute mediastinitis (inflammation from neighboring conditions)
-Granulomatous-Aspergillosis, histoplasmosis, tuberculosis, cryptococus, atypical mycobacteria
- Idiopathic sclerosing
Congenital
Neoplastic

9

Mediastinal tumors

Anterior- usually thymic ca or growth, Mets
Midde- Mets and percardial/bronchogenic cysts
Posterior- neurogenic tumors

10

Congenital cyst

Mediastinal cyst
unilocular
simple cuboidal epithelium filled with serous fluid

11

Thymic hyperplasia

Thymic follicular hyperplasia assosciated with myesthenagravis and autoimmune disorder
-epithelials mixed with lymphocyte follicles

12

Thymoma

Thymic epithelials
lots of immature T cells
Spindle or round cells as well

Large lobulated circumscribed gray/white thymic tissue
Type A- spindle
Type B- Round

Excise

13

Thymic carcinoma

Looks like other carcinomas
Diagnosis of exclusion